Objectives: To explore the efficiency and safety of Sanhuang Xiexin decoction in the treatment of acute ischemic stroke (AIS) patients after endovascular intervention examination. Methods: In this prospective observational study, 121 AIS patients admitted in our hospital were enrolled from January 2012 to December 2015. They were randomly divided into two groups, 61 patients received Sanhuang Xiexin decoction + basic treatment (SX group) and 60 patients received basic treatment (control group). The prescription of Sanhuang Xiexin decoction was taken in the SX group, with one dose (100 ml), twice a day for 7 days orally. For all patients, blood samples were drawn on the first morning and sixth morning after endovascular intervention examination under fasting state for Fib (fibrinogen), PAgT (platelet aggregation test), CRP (C-reactive protein), and TMAO (trimethylamine oxide) tested. Estimate the changes in plasma Fib, PAgT, CRP, and TMAO levels and the syndrome of fire-heat scores. Results: The plasma Fib, PAgT, CRP, and TMAO levels in the SX group were significantly lower than those in the control group (P-Fib < 0.01, P-PAgT < 0.01, P-CRP = 0.02, P-TMAO < 0.01). The syndrome of fire-heat scores in the SX group was significantly lower than that in the control group (p < 0.01). The incidences of ischemic cerebrovascular events within 3 and 6 months after endovascular intervention treatment in the SX group were lower than those in the control group (P-3month = 0.04, P-6month = 0.03). Conclusions: The prescription of Sanhuang Xiexin is efficient and safe in the treatment of AIS patients after endovascular intervention examination through reducing the inflammatory factors.